Dr Anindya Banerjee is our experienced specialist nephrologist. His goal is to help optimise and manage kidney function following a renal transplant and manage any complications, those on dialysis and geriatric patients with multiple comorbidities including diabetes and ischaemic heart disease.
His special interests include
- hypertension
- chronic kidney disease
- hypertensive disorders of pregnancy
What is Renal Hypertension?
The kidneys are two bean-shaped organs, each about the size of a fist located just below the rib cage with one on each side of the spine. Their function is to filter about 110 to 140 litres of blood to produce about 1 to 2 litres of urine. When the kidneys receive low blood flow due to damage in the blood vessels in the kidney, they act as if the low flow is due to dehydration. So they respond by releasing hormones that stimulate the body to retain sodium and water. Blood vessels fill with additional fluid, and blood pressure goes up.
Renal hypertension is elevated blood pressure caused by damaged blood vessels in the kidney, ie kidney disease. The narrowing in one or both renal arteries is most often caused by atherosclerosis, or hardening of the arteries. This is the same process that leads to many heart attacks and strokes. Renal hypertension is caused by a narrowing in the arteries that deliver blood to one or both kidney. It can usually be controlled by blood pressure drugs.
Chronic kidney disease
Chronic kidney disease (CKD) or kidney failure is the gradual or total loss of kidney function where the kidneys’ ability to filter wastes and excess fluids from your blood is impaired. In the early stages of chronic kidney disease you may have few signs or symptoms, with the symptoms appearing only when the kidneys are significantly damaged.
Chronic kidney disease can progress to end-stage kidney failure, which is fatal without artificial filtering (dialysis) or a kidney transplant.
Symptoms
- High blood pressure (hypertension) that’s difficult to control
- Fatigue and weakness
- Loss of appetite
- Sleep problems
- Nausea or Vomiting
- Changes in how much you urinate
- Decreased mental sharpness
- Muscle twitches and cramps
- Swelling of feet and ankles
- Persistent itching
- Chest pain, if fluid builds up around the lining of the heart
- Shortness of breath, if fluid builds up in the lungs
Causes
- High blood pressure
- Old age
- Smoking
- Obesity
- Abnormal kidney structure or family history of kidney disease
- Type 1 or type 2 diabetes
- Glomerulonephritis or inflammation an inflammation of the kidney’s tubules and surrounding structures
- Polycystic kidney disease
- Prolonged obstruction of the urinary tract, from conditions such as enlarged prostate, kidney stones and some cancers
- Vesicoureteral – reflux, a condition that causes urine to back up into your kidneys
- Recurrent kidney infection
Hypertensive disorders of pregnancy
Gestational Hypertension or Pregnancy Induced Hypertension (PIH) is high blood pressure encountered during pregnancy, complicating 5-10% of pregnancies. There are 3 common types of gestational hypertension:
- Chronic Hypertension
- Gestational Hypertension
- Preeclampsia
Chronic Hypertension
Occurs with women who have high blood pressure (over 140/90) before pregnancy, early in pregnancy (before 20 weeks), or continue to have it after delivery.
Gestational Hypertension
High blood pressure that develops after week 20 in pregnancy and goes away after delivery.
Preeclampsia
Both chronic hypertension and gestational hypertension can lead to this severe condition after week 20 of pregnancy. Symptoms include high blood pressure and protein in the urine. This can lead to serious complications for both mother and baby if not treated quickly.
Are you at risk for gestational Hypertension?
The following women may have an increased risk of developing gestational hypertension:
- First-time mums
- Women whose sisters and mothers had PIH
- Women carrying multiples babies
- Women younger than age 20 or older than age 40
- Women who had high blood pressure or kidney disease prior to pregnancy
How can I prevent Gestational Hypertension?
There is no absolute way to prevent hypertension. Some contributing factors to high blood pressure can be controlled, while others cannot. Follow your doctor’s instruction about diet and exercise. Some ways you can help prevent gestational hypertension include the following:
Get enough rest and exercise regularly
Elevate your feet several times during the day
Avoid drinking alcohol and caffeine
Minimise salt and use only for taste
Drink at least 8 glasses of water a day
Decrease the amount of fried foods and junk food you eat
Your doctor may suggest you take the prescribed medicine and additional supplements
When to see a doctor
If you have any signs or symptoms of kidney disease. Your doctor will monitor your kidney function by taking urine and blood tests. Your doctor may refer you to a Nephrologist for further evaluation.
